Evaluation of long-term healthcare utilization and costs associated with COVID-19 among adults and children in the US

Aims This study assessed long-term healthcare resource utilization (HCRU) and direct medical costs associated with COVID-19 among adults and children in the United States. Using a large national claims database, we quantified the incremental healthcare burden during the year following a first COVID-19 diagnosis compared to matched controls without a COVID-19 diagnosis. Materials and Methods This retrospective cohort study used data from the IQVIA PharMetrics Plus database. Patients with a COVID-19 diagnosis (U07. 1) between June 1 and November 30, 2022, were matched 1: 1 to non-COVID-19 controls based on age, sex, region, insurance type, Charlson Comorbidity Index, and baseline HCRU. Outcomes were HCRU and all-cause healthcare costs accrued during the post-acute period (≥31 days after first COVID-19 diagnosis), measured cumulatively through 1, 3, 6, 9, and 11 months of follow-up. Generalized linear models estimated cost ratios. Results The study included 944, 627 patients with a COVID-19 diagnosis (U07. 1) and an equal number of matched controls. Compared with matched controls, mean total costs during 11 months of post-acute follow-up were 27% higher among adults (11, 508 vs 9, 040; p < 0. 001) and 42% higher among pediatric patients with COVID-19 (3, 997 vs 2, 812; p < 0. 001). Costs were higher for COVID-19 cases at all follow-up time points. Among adults at the 11-month follow-up time, costs increased with acute infection severity, with mean costs of 10, 372 for outpatients, 36, 848 for hospitalized patients, and 51, 643 for ICU patients, compared with 8, 617, 16, 926, and 17, 620, respectively, among matched controls (all p < 0. 001). Among adults, cost ratios peaked at 1 month of follow-up (1. 32; 95% CI: 1. 31–1. 33) and declined to 1. 15 (95% CI: 1. 14–1. 15) at 11 months. Conclusions There were significantly higher post-acute HCRU and costs among both adults and pediatrics with a COVID-19 diagnosis compared to matched controls without one, with elevated cost differences persisting up to 12 months post-infection.